Every hospital doesn't have to be a major medical center and there are likely many ways to deliver sound healthcare within a smaller building envelope by using the latest in communications, visual and other technology.

That's the thinking behind Kaiser Permanente's "Small Hospital, Big Idea" contest, which opened yesterday with a call from the healthcare organization for creative thinking from architects, engineers and designers as well as multidisciplinary teams and students.

"Innovation often comes from totally unexpected sources," said John Kouletsis, director of strategy, planning and design for Kaiser Permanente's National Facilities Services Department. "Often times, it's not the healthcare architect who has all the ideas."

Kaiser operates 36 hospitals and almost 500 medical buildings, serving some 8.7 million people in nine states and the district of Columbia. Its hospital design templates generally range from 150- to 350-bed facilities.

Traditionally, smaller hospitals of about 100 beds are merely "miniature versions of the big thing," said Kouletsis. The small hospital Kaiser is contemplating would be located on about 30 acres in Southern California, possibly on the fringe of a suburban-rural area, he said.

For its contest, Kaiser is asking entrants to reach beyond standard concepts to design a small hospital to deliver services more effectively and efficiently without compromising patient care. "The winning small hospital design," according to Kaiser, "will provide a patient-centered healing environment that has near-zero impact on the environment while providing access to the latest technology to improve quality and reduce costs."

The contest challenges participants to envision a way of doing that by addressing what has become "a perfect storm" of changing expectations among caregivers, patients and communities when it comes to healthcare, Kouletsis said.

For example, he said, what if there were ways to enable a doctor serving at a hospital located in a suburban-rural fringe to provide ICU care without being at the facility 24/7 for most of the days of the week? Is there a way for time- and resource-challenged patients to have a doctor's visit without taking three hours off from work for a routine 20-minute visit -- for which they have spend most of their time on the road to get the office and then sit waiting for their appointment? Is it necessary for such a small hospital to have a full radiology department? Can the images be taken on site and then sent digitally to medical experts elsewhere, say, at a major facility in the region, for analysis? And what if the small hospital could be used to try out new applications of existing or advanced technology and new ways of providing healthcare, Kouletsis asked.

"We have a lot of hopes about what this could be," he said of the small hospital project. "Kaiser is all about quality healthcare and providing the best care available, but what if you could transform the way you delivery that care ... and use the (small) hospital as a test bed for great ideas as long as it doesn't impact patient quality of care or patient or employee safety?"

More information about the Small Hospital, Big Idea contest is available at http://design.kpnfs.com/. People interested in participating must register by 5 p.m. on March 21. The deadline for submissions to Stage 1 of the contest -- the concept phase --  is 5 p.m. on April 18, with winners for that portion of the contest announced on May 26. The winners, who could receive as much as to $750,000 to develop their concepts further, are to submit their designs by October 28. The winner of the final phase is to be announced on November 4 and will be eligible to contract with the Kaiser for the design of the small hospital project.

^{Image courtesy of Kaiser Permanente.}